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Biomedical subjects

G Giusti

Publications and source records attributed to G Giusti.

At least 55 records · Page 3Linked to original sources

HBV infection among pre-school children in Naples (Italy) and the role of intrafamily contact.

In the Neapolitan area the prevalence of adult HBsAg carriers ranges from 4-7%. Moreover, hepatitis B virus (HBV) is responsible for most of the chronic hepatitis cases in childhood. Since the chronic carrier state in our area is acquired by early horizontal contact, we investigated the prevalence of HBV infection among 207 pre-school children and of HBsAg carriers among their family members. None of the children was found to be HBsAg positive and 3.9% of them had anti-HBs. HBsAg was positive in 29 out of 892 (3.3%) of the family members. There was a clear age-related distribution of the carriers, their prevalence reaching 6.7% among the elderly members. On the whole, 19 out of the 207 index cases had at least one HBsAg carrier in their family. The results suggest that in our area a decline of HBV endemia may be under way and that early intrafamily contact is no more a common pathway in acquiring an HBsAg carrier state.

Age Factors↗

High prevalence of co-occurrence of anti-HCV and anti-HBc antibodies in chronic hepatitis patients from southern Italy.

The prevalence of anti-HCV and anti-HBV antibodies was investigated in a series of 77 adult patients with HBsAg negative, non autoimmune chronic liver disease. Anti-HCV were found in 68% and anti-HBc in 71% of the cases; 68% of the patients carried both antibodies. There was no difference in the proportion of anti-HBc positive cases between the anti-HCV positive or negative patients. The intense circulation of HBV infection in Southern Italy during the past decades might explain the high percentage of subjects with anti-HBc. Whether the co-occurrence of HCV and HBV infection may influence the natural history of the liver disease, remains to be established.

Adult↗

Influence of HDV infection on clinical, biochemical and histological presentation of HBsAg positive chronic hepatitis.

In an attempt to identify some characteristics of HDV infection in the different forms of HBsAg positive chronic hepatitis (CH), we evaluated numerous clinical, biochemical and histological aspects in 203 consecutive HBsAg positive CH patients. The presence of hepatitis delta antigen (HD-Ag) in the liver tissue was the criterion used to identify HDV infection. HD-Ag was observed in none of the 7 patients with non-specific reactive hepatitis, in 14.6% of the 48 with chronic persistent hepatitis (CPH), in 36.4% of the 44 with chronic lobular hepatitis (CLH), in 36% of the 25 with mild chronic active hepatitis (CAH), in 52% of the 36 with severe CAH and in 30.2% of the 43 with inactive or moderately active cirrhosis. Compared with the 139 HD-Ag negative patients in this study, the 64 HD-Ag positive patients more frequently had severe CAH (29.7 vs. 12.2%, p less than 0.01) and less frequently CPH (10.9 vs. 29.5%, p less than 0.01). Of the 139 HD-Ag negative patients, 80 were anti-HD positive and 59 anti-HD negative. The 59 patients with no HD-Ag or anti-HD showed severe CAH less frequently than the 64 HD-Ag positive patients (6.8 vs. 29.7, p less than 0.01) and CPH more frequently (44.1 vs. 10.9, p less than 0.001). Both in CPH and CLH the presence of HD-Ag in the hepatocytes identified subgroups of patients who frequently showed high serum levels of aminotransferases and gammaglobulins and more extended areas of circumscribed lobular necrosis. HD-Ag positive CAH was characterized by a more frequent occurrence of eosinophilic degeneration of hepatocytes without peripolesis (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Endogenous dopamine (DA) and DA2 receptors: a mechanism limiting excessive sympathetic-adrenal discharge in humans.

We studied the effects of presynaptic dopamine (DA) 2 receptor blockade on the sympathetic-adrenal response to graded exercise in seven normal men. DA2 receptor blockade was achieved by means of domperidone (DMP) administration. The exercise consisted of progressive cycling activity, from 30-80% of the predetermined maximal oxygen consumption for each man. Systolic, diastolic, and mean arterial pressures; heart rate; and plasma norepinephrine (NE), epinephrine (E), PRL, glucose, lactate, FFA, sodium, potassium, cortisol, and PRA were measured at rest, during exercise, and during recovery after placebo or DMP administration. Graded exercise caused significant increases in systolic and mean arterial pressures and plasma NE, E, lactate, sodium, potassium, FFA, cortisol, and PRA. DMP administration before exercise caused a significant increase in plasma PRL (P = 0.0009), a greater increase in plasma NE at the end of the exercise (P = 0.002), and an overall increase in plasma E (P = 0.02) and FFA (P = 0.02) concentrations. These results strongly suggest that endogenous DA limits catecholamine release during sympathetic-adrenal stimulation by activating DA2 receptors.

Adrenal Glands↗

Cyclical Cushing's disease: report of a case cured by conventional cobaltotherapy.

Preliminary hormonal studies in a 18-y old man with the clinical features of Cushing's syndrome showed inconclusive and conflicting results both in basal conditions and after metyrapone and dexamethasone administration. Therefore the possibility of a cyclical or acyclical fluctuation of adrenal hypersecretion was suspected and the patient was observed for an extended period of time free of hormonal manipulations. Regular cycles of cortisol hyperproduction, with peaks occurring every 6.0 days were found. Ectopic ACTH production was ruled out and, even in the absence of radiological evidence of a pituitary adenoma, conventional cobaltotherapy was suggested after refusal of transsphenoidal pituitary surgery. About 8 months later a marked clinical improvement was evident as well as normalization of hormonal data with loss of the cyclical pattern. Remission of the disease was still persistent 15 and 28 months later. A recent control, approximately 4 1/2 yr after treatment confirmed the normalization of biochemical data, suggesting a cure of the disease.

Adolescent↗

The role of surgery in transmitting "post-transfusion hepatitis".

The role of surgery as an additional risk in transmitting "post-transfusion" hepatitis was investigated in a retrospective study on acute hepatitis occurring in 77 transfused patients, 293 transfused and operated patients and 243 hepatitis cases with history of surgery without transfusion. Hepatitis A patients admitted to the same centres in the same period were utilized as controls. In transfused patients the percentage of NANB hepatitis was higher than that of type B (61.0% vs. 36.4%), while in the operated not transfused group the percentage of type B was twice that of type NANB (63.4% vs. 32.5%). In transfused and operated cases intermediate values were observed. The age-adjusted measures of association between exposures and the different hepatitis types showed a lack of effect of transfusion and a dominant role of surgery in transmitting type B hepatitis. In contrast, NANB "post-transfusional" cases were actually a mixture of post-transfusional and post-surgical cases, since both these exposures were found to be significantly associated with the disease. Our results suggest that studies on the incidence and the etiology of post-transfusion hepatitis should take into account the risk of surgical exposure which might have occurred.

Hepatitis A↗

Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies.

This paper reviews the complications that arose after 68 276 percutaneous liver biopsies performed from 1973 to 1983. The complications are analyzed in relation to the underlying liver disease and to the type of needle used. Death was infrequent (9/100 000); it was always due to haemoperitoneum and occurred only in patients with malignant diseases or cirrhosis. Complications were less frequent in AVH (44/100 000) than in other liver diseases (from 125 to 278/100 000). Death, serious haemorrhagic complications, pneumothorax and biliary peritonitis were more frequent after biopsy with the Trucut needle than after biopsy with Menghini's needle (3/1000 against 1/1000). Sixty-one percent of complications were discovered within two hours of biopsy and 96% within one day. The data indicate a post biopsy observation period of at least 24 hours. The day-case procedure should be reserved for patients not presenting liver tumour or cirrhosis.

Biopsy, Needle↗

Opioid modulation of normal and pathological human chromaffin tissue.

To evaluate whether opioid receptor blockade might modulate sympathetic-adrenal activity, we studied the effects of placebo or naloxone administration on plasma catecholamine (CA) levels in a group of 13 normal subjects and 15 hypertensive patients suspected to have a pheochromocytoma. Diagnostic evaluation confirmed the presence of pheochromocytoma in 9 patients. Among these, 4 had a unilateral epinephrine (E)-secreting tumor, 3 had bilateral E-secreting tumors due to multiple endocrine adenomatosis type IIa, and 2 had a unilateral norepinephrine (NE)-secreting tumor. In each subject studied, CA secretion was evaluated by calculating the area (0-30 min) under the plasma hormone curves after placebo or naloxone administration. In normal subjects naloxone caused a significant increase (P less than 0.005) of E secretion, whereas NE did not change. Similarly, in the group of hypertensive patients, E secretion increased after naloxone (P less than 0.01). In pheochromocytoma patients naloxone caused a significant increase in E (P less than 0.05) and NE (P less than 0.01) secretion from E-producing tumors but no increase in the patients with NE-secreting pheochromocytomas. The study suggests that CA secretion from normal and pathological chromaffin tissue is modulated by endogenous opioids; this modulation seems particularly evident in patients with E-secreting pheochromocytoma.

Adolescent↗

Ciprofloxacin in the treatment of urinary and respiratory tract infections in patients with chronic liver disease.

The clinical efficacy and tolerability of ciprofloxacin (Bay o 9867), a new quinolone compound with broad antibacterial spectrum, was evaluated in 28 patients hospitalized in the first Clinic of Infectious Diseases, University of Naples, Italy, for chronic liver disease and affected by respiratory (RTI) or urinary tract infections (UTI). Ciprofloxacin was administered at the dosage of 500 mg twice a day after the isolation of the organism responsible for the infection and after the determination of its sensitivity in vitro to ciprofloxacin. The therapy was carried on for 5-10 days depending upon the severity of infection and clinical evaluation. Bacteriological cultures and hematochemical analysis were always performed during and after the therapy. Ciprofloxacin was very effective in all the treatments of UTI and RTI under examination, both for the disappearance or improvement of clinical signs and for eradication of the responsible microorganisms. No significant side effects or change in the hematochemical tests were observed.

Adult↗

Characterization of the effects of erythromycin estolate and erythromycin base on the excretory function of the isolated rat liver.

To investigate the mechanisms of erythromycin cholestasis, the effects of erythromycin estolate (EE) on the excretory function of the isolated perfused rat liver and on liver plasma membrane (LM) preparations were studied and compared to those of erythromycin base (EB) and lauryl sulfate (LS), added alone or in combination. EE (at 125 to 200 microM) caused dose-dependent reductions of bile and perfusate flows, bile acid (BA) excretion, and biliary BA concentration. The alterations of the excretory function were only in part due to the decreased perfusate flow. In contrast, both 200 and 300 microM concentrations of EB elicited similar choleretic responses, which were presumably related to the osmotic activity of the drug excreted in the bile. LS did not affect hepatic excretory functions. However, the simultaneous addition of EB and LS resulted in a rate of bile flow lower than that observed with EB alone. EE, but not EB, increased canalicular permeability to [14C]sucrose as measured by bile to plasma (B:P) ratio. Neither drugs altered [14C]erythritol B:P ratio. In LM preparations both Na+,K+- and Mg2+-ATPase activities were inhibited in a dose-dependent manner by EE, but not by EB. The data suggest that EE could affect bile flow by inhibiting cotransport of Na+ and BA and by altering LM permeability and support the view that the effect of erythromycins on the liver may be related to their surface activity.

Adenosine Triphosphatases↗

Does endogenous dopamine modulate human sympathetic activity through DA2 receptors?

The effects of placebo and DA2 antidopaminergic agents on basal and stimulated catecholamine (CA) plasma levels in humans have been evaluated by administration either of domperidone or metoclopramide to separate groups of subjects. The latter group was subjected domperidone to sympathetic stimulation by handgrip coldpressor tests, and standing. Pharmacological DA2 receptor blockade, either peripheral by or central and peripheral by metoclopramide, did not modify plasma CA whilst resting or during acute sympathetic stimulation. It is concluded that endogenous dopamine does not seem to play a significant role in modulating NE release in man, at least not under the physiological conditions examined.

Adult↗

Blind-ending branch of bifid ureter: report of seven cases.

Seven cases of bifid ureter with a blind-ending branch are presented: diagnosis was primarily made by excretory urogram. In 1 case the diagnosis was confirmed by retrograde pyelogram. The pelvicalyceal system showed ureteroureteral reflux into the blind-ending branch on photofluoroscopy and cineroentgenography. One rare case of blind-ending branch originating in the upper third of the ureter are described. The clinical aspects, roentgenographic findings, and treatment of these findings are reviewed.

Adult↗

The incidence of urinary tract malformations in congenital heart disease.

A statistically significant number of congenital heart disease patients were evaluated for urinary tract anomalies. Twelve percent (160 cases among 1340 patients) had such associated anomalies. However, no association between a specific congenital heart disease and a particular urinary tract anomaly could be found. The results were very similar to those reported in clinical series, but slightly higher than those found at autopsy. The percentage of urinary tract malformations varied over a wide range, with some congenital heart disease having a much higher association than others. However, the total average incidence of urinary tract malformation was similar to that of the general population.

Adolescent↗